Recent findings in this prospective study of 50,000 Harvard and University of Pennsylvania alumni have linked lifestyles of the 1960's (including physical exercise) with reduction or postponement of cardiovascular disease, leading to extension of longevity. The proposed continuation will determine whether and how these associations have developed with relation to lifestyle trends of the 1970's and 1980's (including the so-called "exercise revolution" and "cigarette rebellion"). Influences of aging also should be discernable in this extended followup. Thus far some 16,000 alumni have died, 34,000 survivors are aged 53 to 90, and 28,000 respondents have reported on exercise, other lifestyles and health. Resources for observational analyses include: 1) college data from entrance physical examination, social, and athletic records, 1916- 1950; 2) self-assessed mail questionnaire responses from alumni on exercise, other lifestyles, physician-diagnosed disease, and parental disease history, obtained on six occasions, 1962-1980; and 3) death certificates, 1916-date. A projected questionnaire in 1988 wi11 extend information on exercise, other lifestyles, and chronic disease occurrence. This study of college alumni began with a search of student characteristics for early predictors of cardiovascular disease later in life. Next it considered the predictive value of alumni characteristics assessed by questionnaires in the 1960's, for the same outcome. The proposed work will focus on exercise patterns and energy output indices as of the mid 1970's and early 1980's, for relation through 1986 to a) cardiovascular disease mortality, b) all-cause mortality, and c) projected longevity; and through 1988 for d) cardiovascular disease (including hypertension and diabetes) morbidity. A further analysis will assess changing patterns of exercise and other characteristics (e.g., cigarette smoking, body weight-for-height, blood pressure) between the 1960's and 1970's for relationships to those same outcomes. Subsequently we will exmaine lifestyle elements of 1988 for relationships to cardiovascular and all-cause mortality through 1992. These studies should show whether and how a shift from a sedentary to an active lifestyle in mid-life reduces cardiovascular disease risk and extends longevity.